Оценка знаний семейных врачей сектора Ботаника, муниципия Кишинэу о деятельности первичной медицинской помощи и содержании Национальных Клинических Протоколов для взрослых

Nicolae Testemitanu State Medical and Pharmaceutical University, Territorial Medical Association Botanica, Chisinau, Congresul III al Medicilor de Familie din Republica Moldova, 17–18 mai, 2012, Chişinău, Republica Moldova, Conferinţa Naţională „Maladii bronhoobstructive la copii”, consacrată profesorului universitar, doctor habilitat Victor Gheţeul, 27 aprilie, Chişinău, Republica MoldovaThe quality of the primary health care is largely determined by the level of the professional training of family doctors. With the purpose of the quality improvement and standardization of the medical services rendered to the population of the Republic of Moldova, there have been developed the National clinical protocols for adults, which are designed as basis for the institutional protocols. There are more than 160 protocols in the process of implementation in clinical practice. The aim of the study was to assess the level of knowledge on primary health care activities and on the content of a number of National Clinical Protocols for adults, at the family physicians from Botanica district, mun. Chisinau. The results showed a higher level of knowledge of those National Clinical Protocols, for which implementation, doctors took some training programs and spent more time using them in clinical practice. The system of the survey of knowledge is an accessible method for estimating the degree of the implementation of the National Clinical Protocols. In order to accelerate their implementation, the topics of the National clinical protocols should be included in the post-graduate medical education programs.Качество первичной медицинской помощи во многом определяется уровнем профессиональной подготовки семейных врачей. С этой целью и для стандартизации медицинских услуг оказываемых населению Республики Молдова были разработаны Национальные клинические протоколы для взрослых, на основании которых разработаны учрежденческие протоколы. В процессе внедрения в клиническую практику находятся более 160 протоколов. Цель данного исследования: оценка уровня знаний семейных врачей сектора Ботаника, муниципия Кишинэу о деятельности первичной медицинской помощи и содержании ряда Национальных клинических протоколов для взрослых. Результаты продемонстрировали более высокий уровень знания Национальных клинических протоколов, по внедрению которых врачи проходили какие-либо обучающие программы, и которым уделялось больше времени в клинической практике. Система опроса знаний – доступный метод оценки степени внедрения Национальных клинических протоколов. В программах постуниверситетского образования врачей следует продолжить изучение Национальных клинических протоколов для ускорения процесса их внедрения

Образовательные потребности семейных врачей в Республике Молдова в контексте Комплексной Оценки Пожилых Пациентов

Nicolae Testemitanu State Medical and Pharmaceutical University, Congresul III al Medicilor de Familie din Republica Moldova, 17–18 mai, 2012, Chişinău, Republica Moldova, Conferinţa Naţională „Maladii bronhoobstructive la copii”, consacrată profesorului universitar, doctor habilitat Victor Gheţeul, 27 aprilie, Chişinău, Republica MoldovaIntroduction. The population of the Republic of Moldova is about 36 mln. The 65 years old and elder persons represent about 10% of the whole population. During last 10 years the population number is decreasing from 3.639 thousands, in 2000, to 3 562 thousands in 2010. At the same time, the rate of the aged population of the country is increasing - from 325 200 persons, in 2000, to 329 700 persons, in 2011. The aging population was the subject of the study conducted on the request of the National Commission for Population and Development. The health of elderly people and the acces to medical services have been investigated in terms of health self-esteem, existence of chronic diseases and disability, medication use, access to health services and the existence of functional limitations caused by health and need for assistance. According to the esteem of the personal health over the last 10 years, there have increased both, the number of people who believe their state of health as being good and very good, as well as the amount of those who find their state as a bad and very bad one. The seniors’ opinion varies depending on their age and their gender. The number of the persons who were registered as having a disability has also increased. It is also observed an increasing of the proportion of elderly people affected by chronic diseases. The care for elderly people having complex problems requires the collaboration between care-givers, and it strongly depends on the responsible organization. In order to tailor the care in accordance to the individual need of elders, the assessment has to be organized at a lower aggregation level (districts) where professionals know each other well and agreements can be adjusted to local conditions. The urgent need of educating general practitioners about the “new geriatric approaches” is obvious, as patients 65 and older currently comprise 28% of the physician workload in primary care. The Comprehensive Geriatric Assessment (CGA) differs from a standard medical evaluation in three general ways: it focuses on elderly individuals with complex problems, it emphasizes functional status and quality of life, and it frequently takes advantage of an interdisciplinary team of providers. It can be effective only if there is a process for identifying elderly patients who may benefit from it. In the most of cases, they are elderly individuals who are frail and disabled or who have multiple interacting comorbidities, as opposed to relatively healthy older people whose health conditions are addressable by usual medical approaches, and those with serious focal chronic conditions, for whose disease management by primary care with input by other subspecialists is appropriate. Material and methods The educational needs assessment is going to be done, in order to help primary care team with introduction of CGA, by using an evaluation of the competence level of 50 family physicians and nurses through case study methodology. At the same time the number of medical records will be examined to determine the lack of knowledge in the field of Geriatric Care. Results The proposed activities and collaboration, will allow the “Scientific Perspective”, which is a non-commercial organization of researches on health care, from Sainkt-Petersburg, Russia (www. crystalproject.ru), to share its experience on CGA with primary care providers from our country. Our common goal is to disseminate more widely the good practice in Elderly Care and to act for the benefit of aged persons in Moldova